New models of working – sharing the work with online GPs

The Royal College of GPs has published a list of questions for patients, GPs and commissioners to consider before using or utilising online general practice services.

Some of the advice aimed at users includes warnings that the care given might not be as good as their own GP as the online doctor doesnt have access to their records.

“Online consultations can seem like a very convenient option for accessing general practice services, particularly for young, generally healthy people who want to see a GP quickly.
“But the ways some online services are provided raise patient safety concerns – people need to be aware of these, and properly understand what they are signing up to. Often, for example, patients will have consultations with unfamiliar GPs who don’t have access to their full patient records.

I’ve been saying for some time that online GPs should be working with GP practices, not against them. I have an affluent population who might be happy to pay an online GP appointment at a time convenient to them (and just to point out we don’t have an access problem – we had empty appointments yesterday and most people were getting an appointment within an hour of asking).

If a company were to work with my surgery so their aims aligned with ours, I could see us giving them access to our records to help them deliver quality care, if they collected data and recorded in our notes and worked with us not against us e.g. none of this – have an antibiotic and see your own GP first thing. Of course, this is a private service and it would be difficult to let the online service alter or use my prescribing budget ie prescribe on my FP10s but I wonder have these services thought about offering an online service as extra capacity?

Practices routinely pay locums to see patients at £600/day or more. At 30 patients a day (I see more but locums often don’t) that’s £20/patient. Locums can be difficult to find and do I always need a half day or a full day. The ability to buy in some extra capacity might be good. Let’s say the cost is £20 or even better £10.  Could my reception if we were running short of appointments direct some of perhaps the easier calls to the online system and we pay? Could we have a room with a video camera and two-way video and could the online GP deal with hayfever, infected bites, a range of things? Might not need to be a GP – I could buy in a ANP or other? I could even put a HCA in the room with the patient to help in the process – easier to find than GPs.

If as a GP federation we kitted out each practice with such a room could a virtual service supply health care to a group of practices as part of the team? Perhaps we don’t need an external company – perhaps we at enough scale could do it internally? Hire a GP or ANP or both and have them deliver a service to a group of practices online? My feeling is easier to buy it in.